Evidence-Based Research: The Foundation for Treatment Decisions

Evidence-based medicine (EBM) integrates (1) individual clinical expertise, (2) the best current research evidence that is clinically relevant and patient-oriented, and (3) patient preferences, concerns and expectations, into the decision-making process.

Clinical trials, the source of evidence for EBM, are assigned levels of evidence determined by the type and quality of the study. These levels of evidence (1 to 5, 1 being the best) are then tied to grades of recommendation (a, b, c, d). Level 1a, a randomized controlled trial, has become the gold standard for judging whether there is a clear benefit to the treatment and if it should be recommended for patients with similar conditions.

We are seeing a growing number of physicians who understand how research from clinical trials supports their treatment decisions, thus improving their practices and patient care, said David L. Witsell, MD, MHS, Director of Clinical Trials for the Department of Surgery at Duke University Medical Center and Medical Director for the Research Department of the American Association of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNS/F).